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Background and Purpose: No scales measure self-efficacy in women with Type 2 diabetes. A scale was developed and tested. Methods: Items generated, content validity index (CVI) assessed by experts, the 2-part Diabetes Self-Efficacy Scale (DSLF-I and DSLF-II) was piloted with 62 women, administered to 208 women, and then readministered to 30 women to determine initial reliability. Factor analysis was conducted for construct validity. Discriminant, convergent, and predictive validity was examined. Results: The CVI index was 98%. Cronbach's alphas were 0.88 (DSLF-I) and 0.82 (DSLF-II; pilot) and 0.87 and 0.86, respectively (main study); test-retest correlation was .60 (DSLF-I) and .69 (DSLF-II). There were 3 factors that emerged: diabetes knowledge of self-care activity, diabetes diet self-care, and diabetes medication self-care. Conclusions: The Diabetes Self-Efficacy Scale demonstrates good initial reliability and validity.Keywords: instrument development; self-efficacy; diabetes mellitus Type 2; reliability; validity; factor analysisDiabetes mellitus affects 8.3% of the population in the United States, or 25.8 million people. More than 7 million people are estimated to be undiagnosed and unaware they have the disease (Center for Disease Control and Prevention [CDC], 2011). Approximately 90%-95% of persons with diabetes have Type 2 diabetes mellitus (T2DM). The San Antonio Heart Study revealed a rising incidence of T2DM, with age, ethnicity, and neighborhood as significant predictors of T2DM (Burke et al., 1999).Although T2DM affects all ethnic and gender groups, there is a disparate effect. For example, African Americans are 1.6 times more likely to have diabetes than Whites and are more likely to go undiagnosed American Diabetes Association (ADA, 2005a). Complications from T2DM are also more prevalent in minority populations (Carter, Pugh, & Monterosa, 1996). In addition, diabetic women, compared to diabetic men, have a significantly higher prevalence of cardiovascular disease and suffer greater adverse outcomes (D'Arrigo, 1999; Gu, Cowie, & Harris, 1999; Howard et al., 1998; Smitherman & Reis, 1997). Further, Sowers (1998) reported that the gender protectiveness for coronary heart disease (CHD) declines in women between the ages of 50 and 59 years, and that the loss of gender protectiveness increases the risk ratio for CHD to 3.5 for women with diabetes compared to 2.4 for men with diabetes (p. 618). Koerbel and Korytkowski (2003) stated that women with diabetes not only have greater risk for cardiovascular disease but they also suffer greater adverse outcomes. They cite several factors, which increase this risk in women: poorer glycemic control, elevated blood pressure and lipids, central obesity, increased depression and lower socioeconomic status. These factors contribute to increased morbidity and health care costs for women with diabetes. These data support the need for more research into prevention, detection, and cost-effective methods to effectively manage T2DM and prevent its complications in women.Maintenance of health and prevention of diabetic complications require significant changes in lifestyle management and adherence to a therapeutic diabetic regimen. Behavior change and adherence are not only difficult but are also often inadequate to maintain recommended glycemic control (Anderson, Fitzgerald, & Oh, 1993; Skelly, Marshall, Haughey, Davis, & Dunford, 1995). The importance of participation in diabetic self-care behavior in achieving glycemic control has been demonstrated by the Diabetes Control and Complications Trial Research Group (1993) for individuals with Type 1 diabetes mellitus (T1DM) and by the United Kingdom Prospective Diabetes Study Group (1998) for individuals with T2DM. This goal is accomplished through a therapeutic alliance among clients, family, and health care providers to promote self-care behaviors and therapeutic modalities (ADA, 2005b). Self-care behaviors include a combination of changing or modifying eating habits, maintaining weight or achieving weight loss, participating in a physical exercise program, self-monitoring of blood glucose, and/or taking oral or injectable medication. …

The present study aimed to assess the association between sedentary behavior and sarcopenia among adults aged &ge, 65 years. Cross-sectional data from the Study on Global Ageing and Adult Health were analyzed. Sarcopenia was defined as having low skeletal muscle mass and either a slow gait speed or a weak handgrip strength. Self-reported sedentary behavior was assessed as a continuous variable (hours per day) and also as a categorical variable (0&ndash, &lt, 4, 4&ndash, 8, 8&ndash, 11, &ge, 11 hours/day). Multivariable logistic regression was conducted to assess the association between sedentary behavior and sarcopenia. Analyses using the overall sample and country-wise samples were conducted. A total of 14,585 participants aged &ge, 65 years were included in the analysis. Their mean age was 72.6 (standard deviation, 11.5) years and 55% were females. Compared to sedentary behavior of 0&ndash, 4 hours/day, &ge, 11hours/day was significantly associated with 2.14 (95% CI = 1.06&ndash, 4.33) times higher odds for sarcopenia. The country-wise analysis showed that overall, a one-hour increase in sedentary behavior per day was associated with 1.06 (95% CI = 1.04&ndash, 1.10) times higher odds for sarcopenia, while the level of between-country heterogeneity was low (I2 = 12.9%). Public health and healthcare practitioners may wish to target reductions in sedentary behavior to aid in the prevention of sarcopenia in older adults.

Key MessageAlthough obesity measures have been consistently associated with a lower FEV1/FVC ratio in adolescents, no previous study has assessed the underlying mechanisms of this association This population-based study assessed whether insulin resistance and CRP levels at 15 years partially mediate the association between fat mass and FEV1/FVC using a causal mediation analysis approach. The findings suggest that insulin resistance at 15 years may mediate over 20% of this association, but no evidence of a mediating role of CRP was found. Further, longitudinal studies that evaluate other biomarkers of systemic inflammation and examine other potential mechanisms are needed to better understand the pathways linking obesity and respiratory health in adolescence. This is key for public health interventions and targeting clinical interventions.AbstractBackgroundWe previously reported an association of high fat mass levels from age 9 to 15 years with lower forced expiratory flow in 1 s (FEV1)/forced vital capacity (FVC) ratio (i.e., increased risk of airflow limitation) at 15 years. Here, we aimed to assess whether insulin resistance and C-reactive protein (CRP) at 15 years partially mediate this association.MethodsWe included 2263 children from the UK Avon Longitudinal Study of Parents and Children population-based cohort (ALSPAC). Four fat mass index (FMI) trajectories (“low,” “medium-low,” “medium-high,” “high”) from 9 to 15 years were previously identified using Group-Based Trajectory Modeling. Data on CRP, glucose, insulin, and post-bronchodilator FEV1/FVC were available at 15 years. We defined insulin resistance by the homeostasis model assessment-estimated insulin resistance index (HOMA-IR). We used adjusted linear regression models and a causal mediation analysis to assess the mediating role of HOMA-IR and CRP.ResultsCompared to children in the “low” FMI trajectory, children in the “medium-high” and “high” FMI trajectories had lower FEV1/FVC at 15 years. The percentage of the total effect explained by HOMA-IR was 19.8% [−114.1 to 170.0] and 20.4% [1.6 to 69.0] for the “medium-high” and “high” trajectories, respectively. In contrast, there was little evidence for a mediating role of CRP.ConclusionThe association between mid-childhood fat mass and FEV1/FVC ratio at 15 years may be partially mediated by insulin resistance.

The authors would like to thank the children and parents who participated in the study and Ana Yara Postigo-Fuentes for the assistance with the English editing., Sedentary habits during childhood are associated with adverse health outcomes. The aim of this work was to cluster lifestyle behaviors and metabolic biomarkers to establish different patterns in children. Their physical and sedentary activities were evaluated by accelerometry, and questionnaires that included lifestyle behaviors, such as adherence to a Mediterranean diet, anthropometry and blood biochemical markers. Cluster analysis was performed to establish different groups based on physical activity levels. A total of 489 children were finally selected. Cluster 1 included children with a mostly sedentary state, whereas Cluster 3 included the most active children and Cluster 2 included children that did not fit into either the sedentary or the highly active groups. In Cluster 3, 56% of children were in a sports club, and a lower percentage used electronic devices in their rooms compared to the other groups. Cluster 1 children exhibited higher insulin, HOMA-IR and triacylglycerides with respect to the other groups. No differences were found regarding adherence to a Mediterranean diet. The choice to practice an extracurricular sport could be an influencing factor to increase exercise and ensure an active lifestyle in children. Reducing or limiting screen time mainly in children’s rooms could contribute to an active lifestyle., Plan Nacional de Investigacion Cientifica, Desarrollo e InnovacionTecnologica (I + D + I), Instituto de Salud Carlos III-Health Research Funding (FONDOS FEDER) PI051968 PI1102042 PI1600871, Redes tematicas de investigacion cooperativa RETIC (Red SAMID) RD12/0026/0015, Instituto de Salud Carlos III IFI17/00048

血栓や動脈硬化などの予防効果のあるｎ－3系脂肪酸やオリーブオイルを動物性あるいは植物性たんぱく質と同時に摂取した場合の体重に及ぼす影響について検討を行った。さらに，ストレスの関与が体重変化に及ぼす影響についても検討を行った。 実験飼料組成のたんぱく質は動物性のカゼインと植物性の大豆たんぱく質(20en%)，脂質ははオリーブオイルとｎ－３系のエゴマ油，オリーブオイルとシソ油との油(22en%)を使用し，その他の成分は各群とも同じとした。 動物性たんぱく質であるカゼインの方が，大豆たんぱく質よりどの植物油とでも体重増加量は有意に高かった。これはストレスの有無に関わらず同じ傾向であった。また，体重1g増加するのに消費した餌の量はカゼインの方が大豆たんぱく質より有意に少なかった。エゴマ油の場合，ストレスではコントロールより体重増加の抑制が認められた。 血液中のトリアシルグリセロール(TG)値は，ストレスでオリーブオイルのカゼイン群がエゴマ油の大豆群より有意に高かった。一方，肝臓のTG値はストレスで高くなる傾向がみられ，オリーブオイルおよびエゴマ油，混合油ともにカゼインは大豆たんぱくより有意に高かった。 以上の結果より体重変化では，脂質の選択だけでなく動物性や植物性たんぱく質との組み合わせさらにストレスの影響もあるので，目的に応じて脂質とたんぱく質の組み合わせを考慮する必要性が示唆された。, In the present study, we investigated the effect of proteins of both animal and plant with n-3 fatty acid and olive oil on the body weight of rats. Further, we investigated those effects under the stress. Experi- mental diets contained 20 energy % of proteins of casein or soy and 22 energy % of fats of olive oil or egoma oil. The rest of compositions were the same. The results showed that the rat's body weight increased significantly higher by casein than soy protein with both olive and egoma oils in spite of stress. In the amount of food consumption to increase 1g of body weight, casein showed significantly lower than soy protein. Further, the stress suppressed body weight of egoma oil significantly in spite of either proteins than control.In triacylglycerol(TG) of plasma, olive oil showed significantly higher than egoma oil with soy protein under the stress. The stress affected to increase TG in the liver, and casein showed significantly higher than soy protein with olive oil and egoma oil.Our data indicated the association of the source of proteins and the stress with vegetable oils in obesity. The findings suggest that the combination of the protein and vegetable oil is important to control the body weight.

International audience; AbstractSedentary behaviour (SB) has emerged as a potential risk factor for metabolic health in youth. Knowledge on the determinants of SB in youth is necessary to inform future intervention development to reduce SB. A systematic review was conducted to identify predictors and determinants of SB in youth. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched, limiting to articles in English, published between January 2000 and May 2014. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour, (b) determinants, (c) types of sedentary behaviours, (d) types of determinants. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Cross-sectional studies were excluded. The analysis was guided by the socio-ecological model. 37 studies were selected out of 2654 identified papers from the systematic literature search. Most studies were conducted in Europe (n = 13), USA (n = 11), and Australia (n = 10). The study quality, using the Qualsyst tool, was high with a median of 82 % (IQR: 74–91 %). Multiple potential determinants were studied in only one or two studies. Determinants were found at the individual, interpersonal, environmental and policy level but few studies examined a comprehensive set of factors at different levels of influences. Evidence was found for age being positively associated with total SB, and weight status and baseline assessment of screen time being positively associated with screen time (at follow-up). A higher playground density and a higher availability of play and sports equipment at school were consistently related to an increased total SB, although these consistent findings come from single studies. Evidence was also reported for the presence of safe places to cross roads and lengthening morning and lunch breaks being associated with less total SB. Future interventions to decrease SB levels should especially target children with overweight or obesity and should start at a young age. However, since the relationship of many determinants with SB remains inconsistent, there is still a need for more longitudinal research on determinants of SB in youth.

Summary Objective: Our aim was to review the effectiveness of physical activity promotion interventions in the worksite setting in Europe in order to identify those studies that had measured obesity-related outcomes and to evaluate how external validity of the findings had been assessed. Methods: We conducted a review of studies conducted in Europe, published up to December 2009. We assessed levels of evidence regarding effectiveness and analysed external validity using the RE-AIM framework. Results: Studies included (n = 33) were divided in 6 intervention categories. Moderate evidence of effectiveness was found for physical fitness outcomes with exercise training interventions and for physical activity outcomes with active commuting interventions. There was no or inconclusive evidence for obesity-related outcomes for all intervention categories. For external validity, elements receiving the least attention (